| NPI | 1033600952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1859046) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7278) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2023-02-16 |